Recent research shows that the rapid increase in unemployment, loneliness and stress amid the coronavirus pandemic could result in a spike in suicide rates across the negatively affected nations.
The coronavirus pandemic hit the world worst; containing the virus while treating the infected with less knowledge about the same is a challenge for the medical professionals and scientists. However, currently, less attention is given to the psychiatric consequences of the COVID-19 crisis.
Multiple lines of evidence indicate that the COVID-19 pandemic has severe psychological and social effects. There is a pervasive awareness of uncertainty over the future and an understanding that the pandemic is far from over. Apart from the economic poverty and political upheaval, the psychological sequelae of the pandemic is expected to persist for years to come.
World Health Organisation (WHO) by March-end states that mental health is an inseparable part of public health and significantly impact countries and its population, economic capital and social. To support mental and psychosocial well-being in different target groups during the outbreak is imperative.
Previous outbreaks, fear, and suicide
Nothing in our lifetimes can be compared with the magnitude of disaster brought by COVID-19. The last comparable crisis was to fight the H1N1 pandemic in 2009 resembling to actions taken to battle the Spanish flu. Nearly one-third of the population was affected by the Spanish Flu viruses, and at least 50 million people died.
A significant rise in suicides was reported from several countries worldwide during the 1918–1920 pandemic; many of which were due to mental disturbances from the fear of contracting the disease or the stress of infection with the flu itself. Also, a significant decrease in the social integration and interaction, isolation of mass public spiked the suicide rate.
In the present pandemic, researcher has warned that secondary outcomes of social distancing could increase the risk of suicide, emphasizing the effect of changes in a variety of economic, psychosocial, and health-associated risk factors.
Psychological impact of COVID-19
Multiple research has been conducted to understand the impact of coronavirus crisis on mental health of the general population, health care professionals and individuals with psychiatric disorders.
The psychological conditions of people have declined since the outbreak, wherein they showed moderate to severe depressive symptoms, psychological distress, anxiety, anger rose, which resulted in reduced sleep quality, harmful alcohol use and decrease in mental well-being.
Suicidal behaviour during COVID-19 era
Social isolation, anxiety, fear of disease, uncertainty, chronic stress and economic difficulties may lead to the development or worsening of stress-related disorders and suicidality in vulnerable populations including individuals with pre-existing psychiatric disorders, low-resilient persons, individuals who reside in high COVID-19 prevalence areas and people who have a family member or a friend who died because of the virus.
From a suicide prevention perspective, it is troubling that the most critical public health approach for the COVID-19 pandemic is social distancing.
Factors that may cause Psychological disorder or suicidal behaviour during pandemic
- Economic downturn
Economic impacts of the COVID-19 can negatively influence the population’s well-being, especially mental health. The economic slowdown would and will increase the stress level among the people. Government’s around the world need to work upon this downfall and try to minimize the effect so that not only the economy but also the people’s mental well-being can be protected.
- Effect of Recessions and unemployment on mental health and suicide
A research conducted by the University of Oxford shows, the Great Recession, which began in 2007 could be linked at least 10,000 economic suicides across Europe and North America between 2008 and 2010.
Scenario In India
A recent study by a group of researcher shows that suicide was the leading cause for over 300 “non-coronavirus deaths” reported in India due to distress triggered by the nationwide lockdown. It also revealed that there had been a tremendous number of suicides, caused by fear of infection, loneliness, lack of freedom of movement, and alcohol retreat during the lockdown.
Survey by the Indian Psychiatry Society (IPS) reveals that the number of mental illness cases had increased by 20 per cent during lockdown, and that at least one in five Indians were affected.
The IPS warned that the loss of livelihood and increasing levels of economic hardship, isolation, and the rise in domestic abuse amid the pandemic could trigger a new mental health crisis in India and may substantially raise the risk of suicide.
Reports by the National Crime Records Bureau reveals that India reported about 381 suicides daily in 2019, marking an increase of nearly 3.4 per cent suicide deaths as compared to 2018.
WHO reports shows that more than 50 per cent of the suicides globally were committed Indians, making India the highest suicide rate nation in the South-East Asian region.
Suicide prevention during COVID-19
Committee on Prevention of Mental Disorders under the National Academy of Medicine suggested that prevention of psychiatric conditions should be divided into three categories: universal preventive interventions, selective preventive interventions and indicated preventive interventions.
A universal approach is designed for everyone in the general population regardless of their risk for suicide. It is imperative to reduce the stress, anxiety and other mental disturbances by traditional and social media campaigns during COVID-19. Suicide prevention helplines should be made available, and integration of basic mental health services into outpatient primary care may help to minimize the harmful psychological effects of the COVID-19 crisis.
Also, the Governments and non-governmental organizations should provide financial support for people in needs.
A selective approach is for subgroups at increased risk for suicide, for instance, for individuals with a history of psychiatric disorders or symptoms of significant emotional distress, COVID-19 survivors, frontline health care professionals and older adults. Active outreach is necessary, especially in the case of people with a history of psychiatric disorders. Telemedicine can improve the accessibility of mental health care also vulnerable individuals should be advised to limit watching, reading or listening to instigating news.
An indicated approach for individuals who have a risk factor or condition that puts them at very high chance for suicide, e.g. a recent suicide attempt. Individuals in suicidal crises need special attention and constant follow up. Clinicians should have well-defined guidelines on how to deal with suicidal individuals.
Some alerts for future
Recessions and social issues will continue to hurt, but need not cause self-harm. Since the majority of suicides occur among people with existing clinical depression, ensuring secondary prevention – access to effective treatment and antidepressants – may also curb the effect of economic shocks on suicide by checking depression linked with financial uncertainty.
Diagnosing depression and suicide potential gains greater importance during periods of economic crisis. Experts say that “mental illness prevention and mental health promotion should be integral parts of clinical management and service planning in times of financial crisis.”
Also, it is vital to anticipate the changes in socio-psychological needs and planning for mental rehabilitation interventions. These many include 24*7 helplines, wide availability of telephone counselling, mental and behavioural support.
Suicide prevention in this era of COVID-19 and years to come is an important and challenging issue. The methods to mitigate them in times of crisis is known: investment in mental healthcare, including suicide prevention services, and active employment policies, implementation of these actions is what is required.